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Triglycerides Paradox Among the Oldest Old: "The Lower the Better?".

Publication ,  Journal Article
Lv, Y-B; Mao, C; Gao, X; Yin, Z-X; Kraus, VB; Yuan, J-Q; Zhang, J; Luo, J-S; Zeng, Y; Shi, X-M
Published in: J Am Geriatr Soc
April 2019

OBJECTIVES: Currently, most treatment guidelines suggest lowering hypertriglyceridemia of any severity, even in elderly individuals. However associations of serum triglycerides (TGs) with adverse health and mortality risk decrease with age, it remains unclear among the oldest old (aged 80 years and older). The study was to investigate the relationship of serum TG concentrations with cognitive function, activities of daily living (ADLs), frailty, and mortality among the oldest old in a prospective cohort study. DESIGN: Longitudinal prospective cohort study. SETTING: Community-based setting in longevity areas in China. PARTICIPANTS: A total of 930 (mean age = 94.0 years) Chinese oldest old. MEASUREMENTS: The TG concentrations were measured at baseline survey in 2009. Cognitive function, ADLs, frailty, and mortality were determined over 5 years of follow-up. Cox proportional hazards models and competing risk models were performed to explore the association, adjusting for potential confounders. RESULTS: Each 1-mmol/L increase in TGs was associated with a nearly 20% lower risk of cognitive decline, ADL decline, and frailty aggravation during the 5 years of follow-up. Consistently, higher TGs (each 1 mmol/L) was associated with lower 5-year all-cause mortality after fully adjustment (hazard ratio [HR] = 0.79; 95% confidence interval [CI] = 0.69-0.89). Nonelevated TG concentrations (less than 2.26 mmol/L) were associated with higher mortality risk (HR = 1.72; 95% CI = 1.22-2.44), relative to TGs of 2.26 mmol/L or more. We observed similar results regarding TG concentrations and mortality in 1-year lag analysis and when excluding participants with identified chronic disease. CONCLUSION: In the oldest old, a higher concentration of TGs was associated with a lower risk of cognitive decline, ADL decline, frailty aggravation, and mortality. This paradox suggests the clinical importance of revisiting the concept of "the lower the better" for the oldest old. J Am Geriatr Soc 67:741-748, 2019.

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Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

April 2019

Volume

67

Issue

4

Start / End Page

741 / 748

Location

United States

Related Subject Headings

  • Triglycerides
  • Risk Assessment
  • Prospective Studies
  • Male
  • Longitudinal Studies
  • Humans
  • Geriatrics
  • Geriatric Assessment
  • Frailty
  • Female
 

Citation

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Lv, Y.-B., Mao, C., Gao, X., Yin, Z.-X., Kraus, V. B., Yuan, J.-Q., … Shi, X.-M. (2019). Triglycerides Paradox Among the Oldest Old: "The Lower the Better?". J Am Geriatr Soc, 67(4), 741–748. https://doi.org/10.1111/jgs.15733
Lv, Yue-Bin, Chen Mao, Xiang Gao, Zhao-Xue Yin, Virginia Byers Kraus, Jin-Qiu Yuan, Juan Zhang, Jie-Si Luo, Yi Zeng, and Xiao-Ming Shi. “Triglycerides Paradox Among the Oldest Old: "The Lower the Better?".J Am Geriatr Soc 67, no. 4 (April 2019): 741–48. https://doi.org/10.1111/jgs.15733.
Lv Y-B, Mao C, Gao X, Yin Z-X, Kraus VB, Yuan J-Q, et al. Triglycerides Paradox Among the Oldest Old: "The Lower the Better?". J Am Geriatr Soc. 2019 Apr;67(4):741–8.
Lv, Yue-Bin, et al. “Triglycerides Paradox Among the Oldest Old: "The Lower the Better?".J Am Geriatr Soc, vol. 67, no. 4, Apr. 2019, pp. 741–48. Pubmed, doi:10.1111/jgs.15733.
Lv Y-B, Mao C, Gao X, Yin Z-X, Kraus VB, Yuan J-Q, Zhang J, Luo J-S, Zeng Y, Shi X-M. Triglycerides Paradox Among the Oldest Old: "The Lower the Better?". J Am Geriatr Soc. 2019 Apr;67(4):741–748.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

April 2019

Volume

67

Issue

4

Start / End Page

741 / 748

Location

United States

Related Subject Headings

  • Triglycerides
  • Risk Assessment
  • Prospective Studies
  • Male
  • Longitudinal Studies
  • Humans
  • Geriatrics
  • Geriatric Assessment
  • Frailty
  • Female